Polytrauma (Multiple traumas)
Main cause of mortality in population under 40 years;Cause of loss of 41% of potential
years of life;
Injury: Damage following acute exposure to traumatic agents (mechanical energy, heat,
electricity, chemicals or ionizing radiation) in quantities exceeding the threshold of
human tolerance.
Polytrauma: is a syndrome following the action (sometimes simultaneous) of a
variety of traumatic agents (mechanical, physical, chemical) on multiple anatomical
areas of the body, with damage to several anatomical regions or organ systems, in which
at least one injury or combination of several injuries is life threatening, injury severity
being >16on the ISS (Injury Severity Score) and that associates SIRS for a minimum of
24 hours and organ dysfunction or failure, even without their direct damage.
Or trauma with damage to a minimum of two anatomical regions of which at least one
injury is life threatening.
History of Trauma Systems development Closely related to wars
“Who wants to become a surgeon must go to war" (Hippocrates)
Etiology
Traffic accidents (road, railway, sea, air);
Accidents at work;
Assaults;
Falls from height;
Domestic accidents;
Recreational and sports injuries;
War trauma;
Natural disasters
1
, Trauma Scoring
ISS (Injury Severity Score)
based on AIS (Anatomic Injury Severity) = grading the injuries from 7 anatomical regions
(head / neck, face, column, thorax, abdomen, extremities, soft parts) from 1 (minor
injury) to 6 (almost fatal injury)
The sum of the squares of the three highest AIS values;
ISS= (AIS)^2 + (AIS)^2+(AIS)2
Values between 1-75;
<16: mild
16-25: moderate
26-40: severe
> 40: massive (“massive tissue injury”)
RTS (Revised Trauma Score)
The most common physiological score
Glasgow Coma Scale, Systolic Blood Pressure, and respiratory rate
The score range is 0-12
RTS (Revised Trauma Score)
-A patient with an RTS score of 12 is labeled DELAYED (walking wounded)
-11 is URGENT (intervention is required but the patient can wait a short time)
2
Main cause of mortality in population under 40 years;Cause of loss of 41% of potential
years of life;
Injury: Damage following acute exposure to traumatic agents (mechanical energy, heat,
electricity, chemicals or ionizing radiation) in quantities exceeding the threshold of
human tolerance.
Polytrauma: is a syndrome following the action (sometimes simultaneous) of a
variety of traumatic agents (mechanical, physical, chemical) on multiple anatomical
areas of the body, with damage to several anatomical regions or organ systems, in which
at least one injury or combination of several injuries is life threatening, injury severity
being >16on the ISS (Injury Severity Score) and that associates SIRS for a minimum of
24 hours and organ dysfunction or failure, even without their direct damage.
Or trauma with damage to a minimum of two anatomical regions of which at least one
injury is life threatening.
History of Trauma Systems development Closely related to wars
“Who wants to become a surgeon must go to war" (Hippocrates)
Etiology
Traffic accidents (road, railway, sea, air);
Accidents at work;
Assaults;
Falls from height;
Domestic accidents;
Recreational and sports injuries;
War trauma;
Natural disasters
1
, Trauma Scoring
ISS (Injury Severity Score)
based on AIS (Anatomic Injury Severity) = grading the injuries from 7 anatomical regions
(head / neck, face, column, thorax, abdomen, extremities, soft parts) from 1 (minor
injury) to 6 (almost fatal injury)
The sum of the squares of the three highest AIS values;
ISS= (AIS)^2 + (AIS)^2+(AIS)2
Values between 1-75;
<16: mild
16-25: moderate
26-40: severe
> 40: massive (“massive tissue injury”)
RTS (Revised Trauma Score)
The most common physiological score
Glasgow Coma Scale, Systolic Blood Pressure, and respiratory rate
The score range is 0-12
RTS (Revised Trauma Score)
-A patient with an RTS score of 12 is labeled DELAYED (walking wounded)
-11 is URGENT (intervention is required but the patient can wait a short time)
2
